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Medic Mobile’s new Interaction Designer shares insights from her first field visit to Thika, Kenya

May 05, 2017

Posted by: Jill Shah

Amanda Cilek recently joined our team as Interaction Designer. Below, she shares stories and insights from her first ever field visit to Kenya.

I design because I feel compelled to make a difference in the world and because I believe good, thoughtful design can be the perfect catalyst for change. Working with a nonprofit has long been a dream of mine, and I was thrilled to recently join Medic Mobile’s design team as an Interaction Designer.

On the first day of my new job, I was asked if I would be willing to travel to Kenya in just a few weeks to meet our Africa regional team and take part in a field visit. The reason being that I couldn’t very well work on improving our app design until I’d actually met end users and seen the situation on the ground. Wow, what a way to kick off a new job, and what an amazing organization. Medic Mobile is genuinely human-centered in every way. At a time when “human-centered design” and “user experience” are unfortunately becoming trendy catchphrases, I was so pleased to find that Medic takes the time to do things right. Our design initiatives always start with questions and user stories, our process is iterative and inclusive, and user feedback directly informs our final solutions.

My first week in Kenya was spent meeting my fellow colleagues and engaging in lots of team sessions. The second week, a day visit to a nearby deployment site was arranged. We got up early in the morning and headed to Thika, an industrial town about an hour northeast of Nairobi, where our partner Living Goods (LG) operates using our app. Two other Medic Mobile teammates accompanied me - Dianna Kane, our Chief Design Officer, and Michael Kohn, our Data and Analytics Lead.

We began our visit by meeting LG staff at their branch office and speaking with the Acting Manager, Grace. Grace showed us around and explained LG’s unique commission-based model, which empowers community health providers (CHPs) to be health entrepreneurs in their communities through the sale of medicines and supplies. The office has a small warehouse of goods and CHPs come to the office to restock. The LG model motivates the CHPs and rewards them for their hard work while also providing a convenient method of supply distribution in hard-to-reach communities. We were excited to see it working successfully.

Boniface, LG's tech support guru

Next we met with Boniface, an LG tech support guru. Boniface walked us through how he uses our analytics dashboards on a daily basis to get an overall summary of his branch’s performance and find out which underperforming CHPs might require extra help and follow-up. He also explained how his branch likes to call out low and high achievers and reward the highest performing CHPs with additional incentives for doing a great job. Boniface was full of insightful feedback and ideas, and he said he looks forward to seeing future versions of our app.

From left to right: Mary, Michael, Dianna, Amanda, and Simon at the LG office

We also met with Simon and Mary, both of whom are top-performing CHPs. We chatted with them about their work as CHPs and talked through how they use the app. While we were at it, we conducted a few brief UX tests to get feedback on an update our design team is working on. We were glad to have an InVision prototype of our concept ready to go - it seemed even the simple act of being able to scroll the page up and down helped the CHPs’ evaluation and comparison with the existing app tremendously. All of the feedback was incredibly helpful. We’ve learned not to get too attached to our ideas until they are tested and this visit was yet further proof that no matter how well-intentioned we are, or how diligent our thought process, nothing can replace actually making a prototype and observing what users do with it. We left with a list of updates and potential new ideas to help improve our design.

Afterwards, we departed the LG office to meet another CHP, Rachel, in her home area nearby. The drive was about a half hour on rough mud roads and we had to keep a slow pace due to the poor conditions. I was struck by how remote the community felt despite being relatively close to Thika - we passed by few other vehicles on the main road and once we turned off to our destination, ours was the only vehicle, and it felt out of place. We arrived at a community of stick and mud huts surrounded by lush green vegetation, located directly across from a pineapple farm.

CHP Rachel, left, and Acting Manager Grace, right

Rachel was waiting for us ready to conduct her visits for the day. She has been a CHV with the Kenyan Ministry of Health for 7+ years and a CHP with LG for 3 years. She’s also a skilled birth attendant, though the government no longer permits the practice at home. As we began our walk to the first home, some adults and children standing outside greeted our group warmly, exchanging pleasantries with Rachel. It is clear that Rachel is known by the whole community, and she tells us people will often come to her to seek out help.

Our first visit was a pregnancy follow-up. The task was assigned to Rachel in the app so she didn’t have to spend time wondering what she should do that day. We arrived at a small clearing with mud houses and once again were greeted warmly. We were offered seats in the shade under a nearby tree and soon after presented with a tray of fresh bananas (grown just nearby of course!).

Rachel conducting an antenatal care visit with Said

The patient was a young woman named Said who was well along in her pregnancy and whom Rachel had seen before. Rachel got out her illustration book and her mobile phone and began the visit, and we tried to observe quietly without getting in the way. Seeing Rachel and the young woman interact was wonderful. Rachel was cheerful and quick to smile. She leaned in close, speaking in soft gentle tones and had a calming demeanor. She used the laminated book to show Said pictures describing what she should expect during and after delivery, and warning signs to look out for. She strongly emphasized the importance of delivering in a clinic with a trained nurse.

Rachel used the Medic Mobile app to log the ANC visit. She went through a series of questions asking about potential warning signs and then paused to explain the reminders for Said to attend her ANC visits, make sure to sleep under a net, take her supplements, and eat well etc. Rachel and Said spent quite a while conversing together and you could tell that Rachel sincerely cared about Said. Afterward, Said said that she felt very well looked after. While we were there, Rachel performed a quick check-in with another child, taking his temperature. The boy had previously been sick and Rachel wanted to make sure he was still doing well. The boy’s sister saw him getting special treatment and wanted in on the action, so she requested to have her temperature taken too. Rachel just smiled and laughed and went along with it all very good naturedly.

We visited a few other households to assess other children, and registered a new woman and child that Rachel met alongside the road. As we wrapped up our visits for the day, Grace, the Acting Manager, confided that Rachel had at one time almost been let go. She was slow to pick up the new technology tools and the team was worried she wouldn’t be able to keep up with requirements. Well, looking at her now you would never know it. Rachel is one of the highest performing CHPs and she does such a great job looking after her community.

In the end, Rachel is the person I am designing for and I will keep Rachel’s story at the forefront of my mind moving forward. It is crucial that our app is easy to learn and use. More than that, it needs to consider older users, users who are not tech savvy, and users who may have poor eyesight. Environmental surroundings are also a huge factor. I often observed Rachel and others holding a hand over their phone to try to block the bright glare of the sun and squinting to see the washed out screen display. This is what user-centered design means - observing, questioning, following - doing whatever it takes to learn and be more informed. Conversations with our partners, health workers and communities allow us to better understand each other’s perspectives and ensure that our app is solving the right problems.

I’m so grateful for this recent experience and can’t wait to dig in deeper to some of the resulting ideas and findings. One thing is very clear: this trip was about connecting with the real people using our technology on a daily basis. It was about keeping an open mind and opening it further. It was about helping me see the world differently through someone else’s eyes. As the author Henry Miller put it,

“One’s destination is never a place but rather a new way of looking at things.”